A.T cetam infusion solution 200mg/ml An Thien treat symptoms of mental syndrome (60ml)

Dosage form Box
Specifications Piracetam
Ingredient An Thien Pharmaceutical Joint Stock Company

Ingredient

Thành phần cho 60ml

Composition information	Content
Piracetam	12g

Uses

indications

A.T cetam is indicated in the following cases:

Adults

Symptomatic treatment of mental syndrome - entity with improved characteristics by treatment such as memory loss, attention disorder and lack of motivation.

Single or coordination in muscle vibration due to the cause of the cerebral cortex.

Dizziness treatment and accompanying balance disorders, except dizziness of vascular or mental origin.

Prevent and reduce the exacerbations in sickle cell disease.

Children

Treatment of difficult to read, combined with appropriate measures such as language therapy.

Prevent and reduce the exacerbations in sickle cell disease.

Pharmacology

Pharmacological group: other nerve stimulants and Hung Tri (Nootropic) group.

ATC code: N06BX03

Mechanism of action

The available data suggests that the basic mechanism of Piracetam is not specialized in cells and organs. Piracetam is physically connected to the polar head of phospholipids in the dose -based cell membrane model, creating a thin restoration of the cell membrane characterized by the formation of flexible drug complexes - phospholipids. This can lead to improved cell membrane stability, which allows membrane proteins and piercing proteins to maintain or restore three -dimensional or folded structure to perform their function. Piracetam acts on nerves and blood vessels.

Pharmacological effects

Mental effect

At the level of neuron, Piracetam performs the activity in the membrane in many different ways. In animals, Piracetam increases many different types of neurotransmitters, mainly through the regulation of the Synap of the density and the activity of the receptor. On both animals and people, the functions related to cognitive processes such as learning, memory, attention and alertness are improved in both normal or impaired individuals, without developing mental or sedative stimulating effects. Piracetam protects and restores cognitive abilities in animals and people after various brain lesions such as hypoxemia, poisoning and electrical impulse treatment. Piracetam protects against changes in brain function and activity due to hypoxemia when evaluated by EEG (EEG) and mental assessments.

Effects on the blood vessel system

Piracetam has hematological effects on platelets, red blood cells and vascular walls by increasing the deformation of red blood cells and reducing platelet aggregation, reducing red blood cells into the vascular wall and reducing capillaries.

Effects on red blood cells

In patients with sickle cell anemia, Piracetam improves the deformation of red blood cell membrane, reduces blood viscosity and prevents the formation of red blood cells.

Effects on platelets

In open studies in healthy volunteers and in patients with Raynaud syndrome, piracetam doses increased to 12 g often accompanied by reduced platelet function depending on the dose depends on the values before treatment (platelet collection tests caused by ADP, Collagen, Epinephrin and release BTG) without significant changes in platelet quantities. In these studies, Piracetam extends the bleeding time.

Effects on blood vessels

In animal studies, piracetam inhibits shrinkage and loses the effect of many different vasoconstrictors. Piracetam has no vasodilation effect and has no "blood robbery" phenomenon, has no effect on slowing blood or flowing upstream or hypotension.

In healthy volunteers, Piracetam reduces the endocardium adhesion to the endothelial blood vessel and also has a direct stimulating effect on the synthesis of prostacycline in the healed endothelial blood vessels.

Effects on coagulation factors

In healthy volunteers, the dose of piracetam to 9.6 g has reduced the plasma concentration of fibrinogen and the elements of Willebrand (VIII: C; VIII R: Ag; VIII R: VW) to 30 - 40% and increases bleeding time compared to before treatment.

In patients with primary and secondary Raynaud's syndrome, piracetam dose of 8 g/day used for 6 months has reduced the concentration of fibrinogen and the elements of Willebrand in plasma (VIII: C; VIII R: AG; VIII R: VW (RCF) to 30-40%, reducing the viscosity of plasma and increases the blood bleeding time compared to the values before treatment.

Dynamic pharmacokinetics

Piracetam's pharmacokinetic characteristics are linear and regardless of time with a small difference between individuals on a wide dose. This is consistent with high membrane permeability, high solubility and minimum metabolism of piracetam.

The half -life time in the plasma of Piracetam is 5 hours. The half -life is equivalent to a healthy adult and the patient. The half -life of the elderly (mainly due to reducing the clearance of the kidneys) and in the object of renal failure. Plasma concentrations in stable state are achieved within 3 days of drug use.

Distribution: Piracetam does not bind plasma proteins and has an integral distribution of approximately 0.6 liters/kg. Piracetam passed the bloody barrier because it was found in the cerebrospinal fluid after using intravenously. At the cerebrospinal fluid, the time of reaching the peak concentration is 5 hours after the use of the drug and the semi -cancellation time is about 8.5 hours. In animals, Piracetam concentration is the highest in the brain at the cerebral cortex (frontal lobe, top lobe and occipital lobe), in the cerebellum shell and background lymph nodes. Piracetam diffuses to all tissues except adipose tissue, through the placenta fence and absorbed into the isolated red blood cell membrane.

Metabolism: It is unclear whether Piracetam is metabolic in the human body. This non -metabolic is shown by the semi -destructive time of a long -term plasma in patients with anaturia and constant drugs found in urine.

Elimination: Piracetam's semi -cancellation time in adults is about 5 hours after intravenous or after drinking. The total apparay is from 80 - 90 ml/min.

The main excretion path is through urine, accounting for 80 - 100% of the dose. Piracetam is eliminated through glomerular filtration.

Before taking A.T cetam infusion solution 200mg/ml An Thien treat symptoms of mental syndrome (60ml)

How to use

Use intravenous infusion.

When it is necessary to use infusion (such as difficulty swallowing, coma) Piracetam can be used in intravenous lines at the recommended daily dose.

In case of using a piracetam injecting, the doctor will first determine the appropriate dose of piracetam. This dose will determine the amount of drug solution to be injected.

In many cases, the dose needed will exceed 1 bottle of injection and rarely some multiplying the exact number of the available injection vials.

Dosage

adults

Symptomatic treatment of mental syndrome - entity and dizziness

Daily dose is recommended in the range of 2.4 g - 4.8 g/day, divided into 2-3 times.

Treatment of muscle vibration due to the cause of the cerebral cortex

Start the daily dose of 7.2 g, then increase 4.8 g every 3-4 days to a maximum of 20 g, divided into 2-3 times. Treatment with other muscle vibration drugs should be maintained at the same dose.

Depending on the clinical benefits achieved, the dose of these drugs should be reduced, if possible. The dose must be determined for each patient by trying treatment.

Once you have started, it is advisable to continue treating with Piracetam as long as the cerebral disease still exists. In patients with an acute attack, the disease can progress well after a period of time and so every 6 months should try reducing the dose or stopping treatment. It should be reduced by 1.2 g of Piracetam every 2 days (every 3 or 4 days in the event of a Lance-adams syndrome to prevent the possibility of sudden recurrence or convulsions due to sudden suspension).

Preventing and reducing the exacerbations in sickle cell disease

Daily dosage is recommended to prevent exacerbations of 160 mg/kg, orally, divided into 4 times.

Daily dosage is recommended to reduce exit of 300 mg/kg, using intravenous lines, divided into 4 times.

When taking a dose of less than 160 mg/kg/day or uneven use, it can lead to recurrence of acute attacks.

Children

Demonstrate treatment for readers in combination with appropriate measures such as language therapy

recommended doses for children in school age (from 8 years old) and teenagers are 3.2 g/day, divided into 2 times.

Preventing and reducing the exacerbations in sickle cell disease

In children 3 years of age and older, the prevention of exacerbations is 160 mg/kg/day, divided into 4 times.

In case of reducing exacerbations, taking a dose of 300 mg/kg/day of intravenous line, divided into 4 times.

When taking a dose of less than 160 mg/kg/day or uneven use can lead to disease relapse.

Can use piracetam for children with sickle cell anemia under the daily dose recommended above. Piracetam has been used in a few children aged 1-3 years old.

Elderly

Should adjust the dose in the elderly with impaired renal function.

When long -term treatment in the elderly, regular evaluation of creatinine is needed to adjust the appropriate dose when necessary.

Patients with renal failure

Contraindicated to use Piracetam for patients with severe renal impairment (renal creatinine clearance below 20 ml/min).

Daily dose is calculated for each patient by kidney function. Please refer to the table below and adjust the dose as directed. To use this dose table, the patient's creatinine clearance is estimated (CLCR) is calculated by ml/min. The evaluation of creatinine (ml/min) can be estimated from serum creatinine levels (mg/dl) through the following formula:

CLCR = {[140 - Age (year)] Use

Normal 80 Commonly used daily dose, divided 2-4 times. Average 30-49 1/3 is often used daily, divided 2 times. determination.

No dose adjustment in patients only has liver failure. Dosage recommendations in patients with liver and kidney failure.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose?

Symptoms of overdose

There are no more harmful reactions related to overdose reported to Piracetam.

The highest overdose is reported by taking 75 g piracetam, bloody diarrhea with abdominal pain, most likely related to very high sorbitol content in the composition of the drug.

How to handle

In case of significant, acute overdose, the stomach drum can be used by using vomiting.

There is no specific antidote for Piracetam overdose. Treatment of overdose mainly treat symptoms and may include hemorrhage. Separation efficiency is 50 - 60% for piracetam.

In case of emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double doses to compensate for missed dose.

Side Effects

When using A.T Cetam, you may experience unwanted effects (ADR):

Agency system frequency Knowing Anaphylaxis reaction, hypersensitivity. Enlightenment. Sleep. Knowing

Abdominal pain, upper abdominal pain, diarrhea, nausea, vomiting. weakness.

Notify the physician with unwanted effects when using the drug.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

A.T cetam contraindicated in the following cases:

Hypersensitivity to Piracetam, other derivatives of pyrrolidon or any ingredients of the drug.

Be cautious when using

need to be very careful when taking the drug for patients in the following cases:

The impact on platelet gathering: Due to the impact of Piracetam on platelet aggregation, careful recommendations in patients with severe bleeding, patients are at risk of bleeding such as gastrointestinal ulcers, patients at risk of hidden blood coagulation disorders, patients with a history of hemorrhage due to hemorrhage, patients need to conduct surgery including dental surgery and patients with anti -coagulopathy.

Renal failure: Piracetam is eliminated through the kidneys, so it should be cautious in the case of renal failure.

Elderly: When long -term treatment in the elderly, regular evaluation of creatinine removal to adjust the dose appropriately when necessary.

Stop drug stopping: Sudden treatment should be avoided because it can cause convulsions or total convulsions in some muscle -shocking rings.

Sacrotage exacerbations in sickle blood cells: With indications in sickle blood cells, dose lower than 160 mg/kg/day or irregular use can lead to recurrence of acute attacks.

The effect of the drug on the ability to drive and operate machinery

With unwanted effects observed after taking the drug, the drug is entitled to driving and operating machinery and this should be noted.

Use drugs for women during pregnancy and lactation

Pregnant women

Do not use piracetam during pregnancy unless it is really necessary, when the benefits are out of the risk and clinical condition of the fetus to treat Piracetam.

There is no enough data on the use of piracetam in pregnant women. Animal studies do not show direct or indirect effects on pregnancy, embryo or fetal development, birth or development after birth.

Piracetam passes through the placenta fence. Drug concentration in infants is about 70% to 90% of the drug concentration in the mother.

breastfeeding women

Do not use piracetam while breastfeeding or non -breastfeeding during piracetam treatment. The benefits of breastfeeding should be taken into account and the benefits of treatment for mothers when deciding not to breastfeed or do not use piracetam. Piracetam is secreted into breast milk.

Drug interaction

Pharmacokinetic interaction: Drug interaction is likely to lead to pharmacokinetic changes of piracetam is predicted to be low because about 90% of piracetam dose excreted through urine in the form of constant.

In vitro, Piracetam does not inhibit the isomers of Cytochrom P450 in the liver CYP1A2, 2B6, 2C8, 2C9, 2C19, 2D6, 2E1 and 4A9/11 at concentrations 142, 426 and 1422 µg/ml. At 1422 µg/ml concentration, observing the slightly inhibited effect on CYP2A6 (21%) and 3A4/5 (11%). However, the ki values to inhibit these two types of CYP isomers are good when the concentration exceeds 1422 µg/ml.

Therefore, the metabolic interaction of piracetam with other drugs is almost none.

Thyroid hormones: Confusion, irritability and sleep disorders have been reported when used simultaneously with thyroid extracts (T3 + T4).

Acenocoumarol: In a single blind study published in patients with severe recurrent vein thrombosis, the piracetam dose of 9.6 g/day does not change the dose of acenocoumarol necessary to achieve Inr 2.5 to 3.5, but compared to the effect of acenocoumarol used alone, the supplement of Piracetam 9.6 g/day is significantly reduced in the globe B-Tromboglobulin, fibrinogen levels and the elements of Willebrand (VIII: C; Vill: VW: Ag; Vill: VW: RCO) and the viscosity of whole blood and plasma.

Anti -epileptic drugs: daily doses of 20 g of piracetam over 4 weeks do not change the peak concentration and bottom concentration of serums of anti -epileptic drugs (carbamazepin, phenytoin, phenobarbital, valproat) in patients with epilepsy are taking stable doses.

Alcohol: Drinking alcohol at the same time does not affect the concentration of piracetam in serum and alcohol content is not changed by a 1.6 g piracetam oral dose.

Cavalry: Due to no studies on the correlation of the drug, do not mix this drug with other drugs.

Storage

Leave a cool place, avoid light, temperature below 30⁰C.

To be out of reach of children, read the user manual carefully before use.

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